A busy week for child survival: delivering on commitments and renewing promises

Today we celebrate the first anniversary of the successful GAVI Pledging Conference, where the world committed to expand immunisation coverage to levels that could avert 3.9 million future deaths by 2015.

Also today, I’m at the launch of the 2012 Countdown Report in Washington DC. Countdown to 2015 is an initiative bringing a range of stakeholders together to track progress towards Millennium Development Goals (MDGs) 4 and 5 in 75 countries, where more than 95% of maternal and child deaths occur.

And later this week, the governments of the USA, India and Ethiopia, in collaboration with UNICEF, will launch A Call to Action and A Promise Renewed, calling for an end to preventable child deaths by 2035.

It’s a week to recognise the progress achieved, and a week to secure new commitments that place equity at the forefront of future progress.

A review of progress

Save the Children produced a progress report to hold donors, GAVI and countries accountable for the promises made at the Pledging Conference.

We found that no donor has reneged on their pledges this year and the funds received by GAVI to date could immunise 62 million children and avert 1 million future deaths. Read this blog in the Huffington Post for more on how vaccination, aid and campaigning works.

The fourth Countdown Report identifies countries that have made substantial gains in expanding coverage of essential health interventions. It also reveals that in many countries the rate of change is inadequate: one third of Countdown countries have made little progress on reducing maternal mortality, and 13 countries have made no progress at all on child survival.

Furthermore, the Countdown Report also analyses disaggregated data and finds – as we did for immunisation in our recent report Finding the Final Fifth – that inequalities in intervention coverage within countries remain substantial and are in some cases widening.

These populations who are left without access to essential health interventions are often the ones who need them most.

Unrealised potential

We know the package of essential interventions that work, including immunisation. We know that this package should be provided in an integrated manner across the continuums of care – from adolescence through pregnancy to the age of five, and from the household to the hospital.

We know that health systems must be strengthened for this to happen; we must ensure enough health workers are trained, supported, distributed, equipped and paid.

We know the policies that facilitate universal coverage of this package without financial hardship.  So why are we still so far off achieving our goals?

Call to Action

Renewed political commitment is imperative to accelerate progress towards MDGs 4 and 5.

At the Call to Action this week, a new target will be adopted that seeks to reduce child mortality in every country to the average of The Organisation for Economic Co-operation and Development (OECD) countries, i.e. 20 child deaths per 1,000 live births.

Leave no child behind

We must learn the lessons of the MDGs, where national averages have masked important inequalities. Without an explicit equity target, the easy-to-reach, ‘low-hanging fruit’ will be the first to benefit, leaving the most vulnerable behind.

If the target adopted is disaggregated by criteria such as household wealth and urban/rural, we can monitor the path to progress and truly hold governments and donors accountable. As we know – what gets measured gets done.

All stakeholders (including governments, GAVI and donors) must make equity a priority in order to accelerate progress and achieve sustainable gains.

Recent research conducted by UNICEF finds that addressing inequalities is not only morally sound but also more efficient.

Strengthen mutual accountability

We’re calling for political commitment to equitably achieve universal health coverage – so that every child is in reach of a health worker, bringing access to the preventive, promotive, curative and rehabilitative healthcare they need.

This requires more money being better used to reach the children and families most in need, as well as targets that prompt equitable progress and strong mechanisms for mutual accountability, as per the recommendations of the Commission on Information and Accountability.

At a meeting hosted by the Partnership for Maternal, Newborn and Child Health (PMNCH) yesterday, I presented our health budget advocacy guide to national networks of civil society, which seeks to inspire and support civil society to strategically engage in domestic health budgets – arguably the most important policy lever.

Meaningful civil society participation in health budgets is an opportunity to be seized as partners build national accountability networks and capacities.

Health is a human right and a public good. Collectively we have the responsibility to realise this right for all.